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Tag Archives: before and after pictures

Breast Revision Surgery Has Unique Challenges

Breast revision surgery in San Francisco

Patient initially underwent bilateral breast augmentation with 275cc normal saline implants. She developed mal-position and high riding implants bilaterally, and presented for replacement of her implants with a larger size and to improve the breast implant position.

Breast revision surgery can pose unique challenges for the breast revision surgeon. Many women in need of breast revision surgery might not have access to their original surgery records. If many years have passed since their surgery, their surgeon might not have their records. Medical retention laws and regulations differ from state to state. For California, it is suggested records be kept for a minimum of 10 years from the date the patient was last seen. However, if the surgeon has retired, the patient probably has no way of getting in contact. In a perfect world, patients should ask for a copy of their records after surgery. However, that doesn’t happen very often.

Breast Revision Complications

When a patient sees a breast revision surgeon after many years, many do not remember what size their implants are or even if they are saline or silicone. The complexity of revision surgery is even higher if the patient has already had one or more previous surgeries and has resulting scar tissue that has formed.

As the patient ages the quality of the breast tissue changes, the skin becomes thinner, and the formation of scar tissue can affect the final result.

Breast Revision Surgery will Cost More

With the complexity of breast revision surgery, the fees may be substantially higher than the original surgery. Patients should not assume that a surgeon who performs a lot of breast augmentation surgeries is equally qualified to do breast revision surgery. There are even Board Certified Plastic Surgeons that may not have the expertise for the possible complications that breast revision surgery may require.

When looking for a breast revision surgeon, do not hesitate to ask the doctor how many revisions he/she performs in a year and be sure to ask to see before and after pictures of patients. Do your homework and select a Board Certified Plastic Surgeon who has extensive experience with breast revision surgery.

Before and After Pictures Speak For Themselves

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989. He has an extensive portfolio of before and after pictures of his patients who have been thrilled with their results.

If you are unhappy with your breasts, call now (415) 898-4161 and meet with Dr. Delgado who will explain what options you have to regain beautiful breasts..

Ruptured Breast Implants? Don’t Wait to Remove or Replace!

Saline Breast Implant Deflation

  Before and After Saline Breast Implant Deflation

Saline Breast Implants Can Deflate

Dr. Miguel Delgado, M.D. informs all breast augmentation patients that they will most likely need breast revision surgery at least once in their life. All breast implants can rupture, some within a few months, some after many years. Saline implants usually deflate quickly, and the saline will be absorbed by the body. In most cases, a deflated saline implant is harmless unless there are bacteria or fungus in the implant which can cause an infection and require immediate attention.

If you have a saline implant that deflates, it will be obvious; it will look like a deflated balloon. See your surgeon right away.

Ruptured Silicone Implants Can be Dangerous

Silicone implants that rupture may not be evident for many years and sometimes are not discovered until they are removed. When a silicone implant ruptures, if you are lucky, the silicone will remain inside the capsule (the scar tissue that naturally forms around the implant) making removal easier.

A more difficult situation is when the silicone leaks outside of the capsule and might migrate to areas of the body that are impossible to remove such as the lymph nodes, under the arms, the lungs or other major organs. Migrating silicone may cause lumps in the breast, armpits, or other areas. It is imperative to have the implant and silicone removed as quickly as possible before the silicone can travel inside the body.

Possible causes of a ruptured breast implant are:
• A fall or intense physical pressure on the implants
• Compression from a mammogram
• Capsular contracture
• Damage from surgical instruments
• Aging of the implants

Silent Rupture Only Detected by an MRI

Silicone implants may not show any evidence of a leak, known as a “silent rupture,” the FDA recommends women have an MRI 3 years after the initial surgery and then every 2 years after that.

It is much harder to remove ruptured silicone implants than it was to put them in. Your original surgeon may not be the best choice for revision surgery. Many surgeons are very experienced in breast augmentation, but many are not skilled for explantation, and many results are disastrous.

Ask that the removal is done ‘en bloc’ which means the implant and all of the scar tissue surrounding it is removed as there can be bacteria or chemicals from the implant remaining.

Choose a Breast Revision Expert for Removal/Replacement

If you are having your implants removed or replaced be sure you seek a Board Certified Plastic Surgeon who will show you before and after pictures of their patients.

Dr. Miguel Delgado, M.D., a Board Certified Plastic Surgeon, is an expert in breast revision surgery since 1989, if you are having any issues with your breasts, call (415) 898-4161 for a consultation today!

Updating Breast Implants After Weight Loss

Weight Loss and Your Breasts

Weight Loss and Your Breasts

Losing a significant amount of weight can be very rewarding. However, if you previously had breast augmentation surgery, you may be disappointed with the results the weight loss has had on your breasts.

Breasts normally store body fat; weight loss and losing fat in the breasts may cause the breasts to sag. If the breasts have less coverage with the loss of fat, the implants may be more visible and might settle into a different position, and the nipples may drop.

Drooping Breasts Can be Fixed!

With a new body shape, the size and type of implants previously selected may no longer be appropriate. How disappointing; after all the hard work to slim down to have, your breasts now be a problem. Do not despair, see a board certified plastic surgeon who will be able to offer breast revision options.

Mommy Makeover in San Francisco
This patient of Dr. Miguel Delgado, M.D. had a large weight loss through diet and exercise. She had a Mommy Makeover consisting of a full tummy tuck, breast reduction, and liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California.

You may need a breast lift with or without implants. A breast lift will reposition the nipples and can add upper pole fullness to the breasts. If implants are to be replaced, the size and profile can be changed to better match your new body.

Most surgeons will recommend that breast augmentation surgery be performed after the patient’s weight has stabilized. The amount of breast volume that will be lost with weight reduction is hard to determine as it is dependent on how much fat versus breast tissue a woman has, and every woman is different. A small amount of weight loss will probably have little to no effect on a woman’s breasts. However, a large amount of weight loss for a woman with a high ratio of fat in her breasts may see a big difference.

Breast Implants Over or Under the Muscle?

If implants are under the muscle the pressure of the muscle will keep the implants shape and won’t change with weight loss, but the breast tissue may sag. If the implants are over the muscle, the weight of the breast tissue might affect the shape of the breasts.

Most women who have breast augmentation surgery usually have only a small amount of fat in their breasts, and that is why they are getting an augmentation. For these women, weight loss will most likely not make a significant difference.

Contact us Today!

call or email Contact Dr. Delgado for a consultation if you are unhappy with your breasts. Call (415) 898-4161 or email info@dr-delgado.com.

Miguel Delgado, M.D. Receives Top 500 Award for 2015 from RealSelf

RealSelf 500 for Miguel Delgado, M.D.

Miguel Delgado, M.D. Top Contributor to RealSelf.com

RealSelf.com is one of the most popular websites that offers information on cosmetic procedures. The site was launched in 2006 and is an outstanding resource for tens of millions of readers around the world. Each year RealSelf awards the top 500 Board Certified doctors with recognition for their contributions to the site. RealSelf has over 12,000 Board Certified member doctors, so being in the Top 500 is a real honor.

Readers are allowed to post any questions they may have about cosmetic treatments or surgeries; they will find they will receive multiple answers from surgeons from all over the United States and beyond.

5 Star Rating from Dr. Delgado’s Patients *****

All surgeon members are Board Certified and have their own page that has several tabs for easy navigation. The first tab shows reviews posted by their patients. Miguel Delgado, M.D. has earned the top rating of five stars out of a possible five stars from his patients in such categories as:
• Bedside manner
• Answers questions
• After care follow-up
• Time spent with me
• And many more

After the “Ratings” tab is the “About” tab giving personal information on Dr. Delgado such as his education, Board Certifications, society memberships, blog posts and articles.

Next is a tab for “Questions and Answers,” where Dr. Delgado’s most popular answers have been posted, out of almost 2,000 answers to date.

Dr. Miguel Delgado, M.D. has Posted Hundreds of Pictures

The next tab is for viewing over 443 before and after pictures of his patients, and also, his 28 posted videos.

There are hundreds of procedures that are reviewed including; mommy makeover, facelift, liposuction, gynecomastia and hundreds of questions about “breast revision surgery.”

For Breast Revision Questions, Call Dr. Delgado

If you have questions about breast revision check out RealSelf.com, but for immediate help, call (415) 898-4161 or email info@dr-delgado for a consultation with Dr. Miguel Delgado, M.D.

Ten Important Questions to Ask Your Breast Revision Surgeon

Breast Revision Specialist Miguel Delgado, M.D.

Before and After Breast Revision Surgery

 

The Consultation

Last month’s blog gave several suggestions in helping you to choose your breast revision surgeon. After all your research and you have picked a surgeon, it is time to meet for your first consultation. The following are ten important questions you should ask, don’t hesitate to write your questions down and take them with you; it is easy to forget when you are finally face to face.

 

Important Questions

1.    Are you Board Certified by the American Board of Plastic Surgery?

2.    Will the surgery be done in a surgery center or hospital? Is it fully accredited?

3.    Is the anesthesiologist Board Certified?

4.    What type of anesthesia will be used?

5.    How many breast revision surgeries do you perform per year?

6.    May I see before and after pictures of your patients?

7.    Do you recommend saline or silicone implants for me?

8.    What size and shape implant would be good for me?

9.    Should my implants be placed over or under the muscle? Why?

10.    Where will the incisions be?

 

Write Down Your Questions                       make a question list

This is not a complete list, but a good starting point. Be sure to add more questions as you think of them, but again write them down, it is easy to forget.

 

Two or Three Consultations are Fine!

If after your consultation you are not totally satisfied with the answers you received, or you are not comfortable with the surgeon, go for a second consultation or even a third. It is important for you to have confidence in your surgeon.

Miguel Delgado, M.D. has been doing breast revision surgery since 1989 and is an expert in breast surgery. If you are having issues with your breasts, or you have had your breast implants for more than 10 years and need an evaluation, contact the office today (415 898-4161) for an appointment with Miguel Delgado, M.D.

When Choosing a Breast Revision Surgeon, Read the Reviews!

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon
★★★★★ Ratings: 4.74 -118 Reviews

 

 

 

 

 

 

 

 

 

 

Breast Revision Surgeon

 

The informed woman knows that she will need breast revision surgery, following her original breast augmentation, at least once in her life and maybe more. When the time comes, many women wonder if they should see their same surgeon or seek out a new one.

If you were happy with your original surgeon and the outcome of your surgery, there is no reason to change surgeons unless you have moved, or your surgeon has retired. If you need to find a new surgeon, there are several factors to consider.

Probably the most important qualification you want to look for is that your surgeon is a Board Certified Plastic Surgeon and one that specializes in breast surgery. Doing a web search can provide you with an abundance of information, in fact so much it may be daunting trying to weed through it all!

Board Certified in Plastic Surgery

Miguel Delgado, M.D. suggests that you choose several surgeons in your area that are Board Certified. Before you even view their website; you might want to bring up reviews that have been posted by previous patients. There are several sites that patients can go to that give ratings from actual patients, some reviews are good, some not so much.

Some of the more popular ratings sites that you can check out are:
1.    Healthgrades.com
2.    Vitals.com
3.    RealSelf.com
4.    LocateADoc.com
5.    Yelp.com

 

Read the Reviews!

 

Some of the sites have different categories to give you an indication on how the doctor and the staff rated. An example of the ratings would be; friendliness of the staff, ease of scheduling an appointment, how long did you have to wait to see the doctor? Did the doctor make you feel rushed? Were all your questions answered? Were you happy with your surgical results? These are all important questions and are valuable information to have before making a decision in choosing a new surgeon.

Don’t be too critical, no one is perfect, one or two bad reviews are not unusual. Some people are impossible to please, look for the majority of the reviews to be good.Once you have found two or three surgeons that have good ratings, go to their website and view before and after pictures to get an idea of the results you can expect.

 

Breast Revision Before and After

Sonoma, California – This is a 38-year-old, female resident of Sonoma who presented to the Novato office in Marin County for evaluation for revisional breast surgery. She underwent a short-scar breast lift in 1995 and then a breast augmentation in 1996 using 120 cc, silicone breast implants. This was done at another facility. Her complaints on presentation to me were high-riding breast implants with breast contractures. She underwent complete capsulectomies on both sides with replacement with 300cc normal-saline breast implants inflated up to 325 cc bilaterally. Her procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the improved contour and projection of her breasts and how well the incisions have healed, especially the vertical breast lift incisional scars.

Call Today!

 

phone

Miguel Delgado, M.D. has been doing breast revision surgery since 1989 and is considered an expert in his field, call (415 898-4161)for your breast revision needs.

Prevention of Capsular Contracture

 

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

Breast Capsular Contracture|San Francisco,CA

 

San Francisco, CABreast Capsular contracture is defined by Wikipedia as a response by the body’s immune system to a foreign object such as a breast implant. The result is the formation of collagen fibers that tighten and squeeze the breast implant.

The cause of capsular contracture, for the most part, remains unknown. Dr. Delgado tells his patients it is not possible to guarantee that a woman will not get a capsular contracture. While it is not always known what may be the cause, there are new theories and  ongoing studies being presented. In general, it is believed a low grade infection or excessive inflammation may be to blame. In particular bio-films have been implicated as the possible primary cause of capsular contracture. Bio-films are bacterial colonies surrounded with a covering protecting them from antibiotics and the immune system. Bacteria present during surgery may create a bio-film around a breast implant. The result may be a low grade infection without puss or becoming red, swollen or hot in the manner of infections that we are familiar with. Bio-film inflammation may cause a thick, tight capsule around the implant.

Before and After Breast Revision Surgery

Before and After Breast Revision Surgery

 

Breast Implant Contracture prevention option

 

There are preventative measures that can be taken to reduce the risk, and women who have a propensity to form capsular contracture should discuss all possibilities with their surgeon.

1.    It appears that the placement of the implants can make a difference. Partial or complete placement of the implants under the muscle versus on top of the muscle has been proven to have less incidence of capsular contracture. It is believed that when implants are placed over the muscle they come into contact with bacteria that can be harbored in the ducts of the breasts.

2. The peri-areolar incision seems to have a higher incidence of capsular contracture than the inframmary approach.

3.    Textured breast implants were designed to reduce the incidence of the development of scar tissue. However, there does not seem to be any advantage for implants under the muscle and a slight advantage for implants placed over the muscle.

4.    Massaging after breast augmentation surgery is believed to help keep the pocket open and reduce the likelihood of capsular contracture. However, it is not recommended for textured implants as they are supposed to adhere to tissue and massaging could interfere with this.

5.    Vitamin E is known to thin the blood and must be avoided 2 weeks before and two weeks after surgery. The use of vitamin E after 2 weeks postoperatively may be of benefit. It is believed that vitamin E softens the collagen fibers, and the capsule is made up of collagen fibers. There are not any studies that neither support nor disprove the use of vitamin E.

Check With Your Plastic surgeon about Breast Contractures| San Francisco, CA

 

Whatever methods are tried, be sure you have the approval of your surgeon. Every patient is unique, and your surgeon will be able to advise you as to what is best for you.

 

Call the Expert

 

Dr. Delgado has been doing breast revision surgery since 1988 and is an expert in his field. Call (415 898-4161) or email (info@dr-delgado.com)today for a personal consultation for any breast revision issues.

Breast Revision Surgery, Choosing a New Implant

 

Miguel A. Delgado, M.D.

Miguel A. Delgado, M.D.

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

 

Reasons for Changing  Breast Implants

 

Dr. Delgado emphasizes to his San Francisco breast revision patients that they will most likely need breast revision surgery at least once in their lifetime and maybe more.

There can be several different reasons for the need of breast revision surgery, the main one being that women want to change the size or type of implants. Other reasons include; capsular contracture, deflation of saline implants, rupture of silicone implants, shifting of position of the implants and changes in the breasts due to aging or weight fluctuations.

Breast implants are always evolving and being improved. If breast revision surgery is to be scheduled, many women opt to change the type of implant to be used. Depending on the issue a woman is having, will help determine the choice for new implants. For example, if a woman with saline implants has wrinkling, she may want to change to silicone.

With so many choices available, a woman needs to have an evaluation with a Board Certified Plastic Surgeon, who specializes in breast surgery, to help guide her to make the right selection for her individual situation.

Silicone or Saline Breast Implants?

Saline implants have an advantage in that the size can be adjusted during surgery as they do not come pre filled as silicone implants do. Saline implants are less expensive and can be inserted through a smaller incision. The advantage of silicone implants is a more natural feel and appearance. Today, 80% of women choose silicone over saline.

Moderate, Moderate Plus or High Profile Breast Implants?

 

The difference between these implants is their diameter and projection. A woman’s chest size will determine which profile is best suited for her.

Smooth or Textured?

 

The majority of implants used today are smooth. The textured implants were designed to reduce the incidence of capsular contracture and appear to do so but only when the implant is placed above the muscle. The disadvantage of a textured implant is a thicker shell which may be more visible through the skin and more easily felt.

Round or Anatomical?

 

Most implants are round, but there is a teardrop shaped or anatomical. The anatomical are textured and therefore have the disadvantages of the textured implants.

With all the variables of breast implants, it is important to choose your surgeon carefully, be sure to ask to view before and after pictures of actual patients.

 

Saline to silicone

Saline to silicone

Dr. Delgado has been performing breast revision surgery since 1988, if you are in need of breast revision surgery, call today (415 898-4161) or email (info@dr-delgado.com) for  a consultation.

Considerations for Changing Breast Implant Size

 

dr-miguel-delgado-300x200

Miguel A. Delgado, Jr., M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

There are several different reasons for breast implant exchange; one of the most common is to change the size of the implants. Many women will wait until they might need a breast revision for something else which will usually occur within ten years of the original breast augmentation, but some who are unhappy with their size may not want to wait.

Dr. Miguel Delgado spends a great deal of time with his patients prior to surgery in determining the correct size, so fortunately dissatisfaction with breast implant size is rarely an issue. For the few women who wished they had a different size, 90% to 95% wished they had gone larger. Usually when trying to decide between two sizes, it is advised to go with the larger of the two.

Women need to have good communication with their cosmetic plastic surgeon and trust his/her opinion when it comes to picking the right size. There are considerations for the surgeon that the patient may not understand. The surgeon wants to maintain the proportion of the breast size to the anatomical dimension of a woman’s body, taking into consideration the relation of the shoulders and hips.

There are three main body types:

1.           Ectomorph –slim, more like a fashion model

2.           Endomorph – pear or hourglass shape where body fat has a tendency to settle in the lower region of the body

3.           Mesomorph –hips are generally the same width as the shoulder, the body is more muscular in shape and body fat is stored fairly evenly over the body

Most women are a combination of body types, so it is essential that she is evaluated by an expertly trained cosmetic plastic surgeon to determine the correct size for her breast implants. However, the wishes of the patient are definitely taken into consideration. The patient needs to understand that if she wants very large implants, she may be limited by the width of her chest.  Other factors help determine the profile of the implants, such as the patient’s age and the condition of her the skin.

Breast revision 3

Santa Rosa, California – A 36-year-old mother of two who presents to the San Francisco office at Union Square for breast revision surgery. She has previously had a breast augmentation using 250cc normal saline implants. Her desire is to have an increase in size and change to silicone breast implants. She underwent removal and replacement using 360cc silicone high-profile implants as well as a tummy tuck and liposuction for a “mommy makeover”. Her surgery was performed at Dr. Delgado’s private surgical facility, Marin Cosmetic Surgery Center in Novato, Marin County, California

Different body types will accommodate different size implants; it is not a one size fits all. Bringing in pictures to the initial consultation will help the surgeon understand the patient’s goals. It is strongly advised that the patient ask to see before and after pictures of the surgeon’s actual patients.

Dr. Delgado’s main goal is patient satisfaction; fortunately he rarely has a patient dissatisfied with the choice of implants as much time is spent in helping the patient come to a decision, including doing the “rice test” which helps her visualize what the outcome will be before surgery.

 

Some breast augmentation patients are anxious to have a breast revision right away if they are not happy with the results. They need to understand that implants normally ride high for the first four months or more, the skin and muscle need to stretch allowing the implants to drop into the correct position. While some patients may think they are not happy with their immediate results, once the implants drop into position, they may change their mind; time must also be given for the patient to adjust to her new body image.

If the decision is to change implants for a larger size, it may be necessary to modify the implant pocket to accommodate larger implants. On the other hand, if a woman wants smaller implants, it is possible a breast lift may be required if there is some degree of skin laxity. Each situation is individual, and depending on what changes are to be made, will affect the cost of breast revision surgery. Breast revision usually is complicated and selection of a Board Certified Plastic Surgeon who specializes in breast surgery is essential.

 

If you have concerns about your breast implants, email and phone iconcall today (415 898-4161)or email (info@dr-delgado.com) for a consultation with Dr. Delgado, who will be able to evaluate your situation and make available to you all your options.